Vitamins A and D Fortification of Milk and Their Impact on Nutritional Status of School Children in Rural Regions of Morocco.

Objectives: Vitamins A and D deficiencies constitute a major public health problem in Morocco. The objective of this study is to assess the impact of consumption of vitamins A and D fortified milk on the nutritional status of school children in rural areas Methods: This study is a double-blinded longitudinal one targeting children, 7-9y old (n = 380). Children were divided in two groups: a non fortified group (NFG) received 200 ml of non fortified UHT milk and a fortified group (FG) received 200 ml UHT milk fortified with vitamin A (retinyl palmitate) and vitamin D (D3) to cover 30% of RDA. Clinical assessment, anthropometry, morbidity, alimentary and socioeconomic surveys, blood samples collection were performed at baseline (T0), 4 months (T4) and 9 months (T9). Vitamins A and D were assessed in serum. Cognitive test based on Raven matrix was assigned to children at T0 and T9. Results: At T9 FG showed: 18% reduction of stunting, elimination of the vitamin A deficiency (from 50% to 4,3%), reduction of vitamin D deficiency (from 60% to 25,5%). Cognitive tests showed no significant difference between the two groups. At T9 in the NFG we observed a decrease in vitamins A and D deficiency prevalence probably due to the fact that non fortified whole milk contains residus of Vit A (27 μg/100 ml) and Vit D (0,5 μg/100 ml) Conclusions: The national strategy of vitamins (A and D3) fortification is a success story in Morocco. This study was performed with the support of "Fondation Centrale Laitière pour la nutrition de l'enfant"

Efficacy Study of the Consumption of Iron Fortified Milk on the Iron Nutritional Status of Children in Morocco.

Objectives: Iron deficiency constitutes a major public health problem in Morocco. In line with the National Strategy for Nutrition 2011 – 2019, we undertook a double-blinded longitudinal efficacy study of consumption of iron fortified milk on iron status of children living in rural region at high altitude Methods: Children (n = 380), aged 7 to 9 years, living under normal conditions and without preliminary deworming, were divided in two groups: a non fortified group (NFG) received 200 ml of non fortified UHT milk and a fortified group (FG) received 200ml UHT milk fortified with iron sulfate to cover 30% of RDA. Clinical assessment, anthropometry, morbidity, alimentary and socioeconomic surveys, blood samples collection and cognitive tests (Raven test) were performed at baseline (T0), 4 months (T4) and 9 months (T9). Hemoglobin was estimated in situ by Hemocue device, ferritine and CRP were assessed in serum. Results: The prevalence of anemia (Hb<11,5 g/dl), for the FG was 2,6% at baseline and 0% at T9. For the NFG, it was 3,4% at baseline and 1,8% at T9. At T9 FG showed a reduction of iron deficiency (serum ferritine<12 μg/L) from 50% to 36,4%. Cognitive tests showed no significant difference between the two groups. Conclusions: The milk is a good vehicle for iron fortification, there was a reduction of Iron Deficiency in FG and no change in NFG. This study was performed with the support of “Fondation Centrale Laitière pour la nutrition de l’enfant”.

Iodine Fortified Milk Reduces Prevalence of Iodine Deficiency Disorder in School Children in Morocco.

Objectives: Iodine deficiencies compromise the health and the development of many school-age children worldwide. The aim of this study was to determine the efficacy of iodine fortified milk consumption among Moroccan schoolchildren (n = 193) in rural region. Methods: Iodine status was assessed in 79 children aged 7–9 y before and after consumption of 200mL UHT fortified milk (providing 30% RDA for iodine) daily for 9-months compared to a control group (n = 114) who consumed non-fortified milk. Anthropometric measurements and urine samples were collected and analysed at baseline, 4 months (T4) and 9 months (T9). Results: Severe iodine deficiency was prevalent among the intervention group. At T4 and T9, there was a marked improvement of severe iodine deficiency in the fortified group (8.9% at the baseline, 1.4% at T4 and 0% at T9). The prevalence of moderate iodine deficiency was reduced from the baseline to the end of the study ranging from 36.8% to 6.4%. While for the mild iodine deficiency, the prevalence was increased at T4 (61.9%) and then decreased at T9 (23.6%). A significant reduction of the prevalence of iodine deficiency was observed in the control group certainly due to the presence of residual iodine in the whole non fortified milk (10.4μg/100ml). Conclusions: The consumption of iodine fortified milk led to a clear improvement of iodine status among schoolchildren of rural. This study was performed with the support of "Fondation Centrale Laitière pour la Nutrition de l'Enfant".